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The fascinating perils of plastic surgery

Cosmetic surgery and striving towards perfection of the body are nothing new. The first plastic surgery techniques date back to 800 BC in India, and there are records of ancient Egyptians and Romans carrying out reconstructive procedures. Karl Ferdinand Graefe first coined the phrase “rhinoplasty” in 1818 in an attempt to de-stigmatize nasal reconstructive surgery, and there was a resurgence of plastic surgery research and development after the first and second world wars in the U.S. and Britain. In more recent history, silicone breast enhancements emerged in the 1960s, and the economic boom in the 1980s, coupled with a flurry of modern-day developments in liposuction procedures, saw a rise in shrinking waists and thighs. Nowadays, surgical enhancements have been featured so often on reality TV and the cover of Playboy that we wouldn’t dream of considering them shocking. Yet there is still debate surrounding these procedures, and two new studies have come out recently reporting on the side effects and efficacy of plastic surgery. One study explores the implications on the brain, while the other investigates the long-term impact on the body.

Body language and facial expressions are a large factor in interpersonal communications, almost as important as language itself. Humans are typically very good at relating to one another by subtly and subconsciously mirroring posture and facial expressions during the course of a conversation. This helps both parties to better perceive what is being expressed and what the appropriate response is. By mimicking a partner’s appearance, you are able to internalize their emotion, as your brain perceives your new expression and interprets the correct sentiment associated with it. When a friend is crying, you know they are upset and adopt their down-turned mouth and furrowed brow to better relate and express your empathy. Alternatively, when someone smiles at you on the street, it is difficult to not smile back and feel an extra bounce in your step. This phenomenon is known as “embodied cognition” and involves the reciprocal relationship between the brain and the body.

However, the USC scientists posit that by paralyzing your facial nerves, Botox (or botulinum toxin) disrupts this process by preventing your face from creating the creases and crinkles that externally express and internally manifest as emotions. The rest of the world may not be able to tell your age or know about that summer you spent in Greece, but it also won’t know that you’re empathizing with them when they tell you that their dog died.

The researchers tested this theory by injecting participants with Botox or a placebo dermal filler and having them perform a common test of empathy. Individuals were shown a picture of a set of eyes and asked to guess the emotion that best matched the ocular expression. Participants who received the Botox injection performed significantly worse on this task than controls, though they were still able to perform with around 70% accuracy.

Study author Dr. David Neal eloquently summarized the results, saying, “When you mimic you get a window into their inner world. When we can’t mimic, as with Botox, that window is a little darker.”

The second study involves the long-term physical effects of liposuction, questioning its enduring efficacy. Long heralded as a quick and relatively noninvasive fix for targeting fat areas, a recent study published in Obesity by researchers at the University of Colorado brings this notion into question. Drs. Teri Hernandez and Robert Eckel reported that people who received liposuction as part of the study had their body fat percentage return to baseline levels within one year of the procedure, as determined by subcutaneous skinfold thickness and MRI scans. However, the suctioned fat did not return to the areas that it was removed from; instead the regenerated fat was redistributed to areas less typically associated with fat storage, such as the upper abdomen and arms.

Scientists think that the gross number of fat cells in your body remains relatively stable throughout your life, determined in infancy and largely dependent on genetics and early diet. Instead, differences in weight gain or loss are typically seen through the size or fullness of the fat cells. These cells also exist in a relatively stable regional proportion throughout the body, relegating where an individual tends to gain or hold weight. However, after liposuction, the remaining tissue from the targeted areas are too traumatized to generate new cells, yet the body still attempts to maintain the balance of its original number. Therefore, new fat cells return after you’ve deleted them, just not in the areas you would expect.

Despite this news, more than half of the control subjects in the study–women who were initially interested in receiving liposuction but agreed to hold off for a year to serve as study controls–still wanted to undergo the procedure.